MR. ALI REZA RAFATJOO M.D.
NPI 1154341907
Family Medicine in Newport Beach, CA

Q: What is Ali Rafatjoo's NPI number?

The NPI number for Ali Rafatjoo is 1154341907. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Q: What is Ali Rafatjoo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Q: When was this NPI record last updated?

The NPPES record for Ali Rafatjoo was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since July 21, 2006PECOS EnrolledAccepts Medicare Assignment

360 SAN MIGUEL DR, SUITE 206, NEWPORT BEACH, CA 92660(949) 640-4455(949) 640-4456 Get Directions Write a Review

NPPES record last updated: March 2, 2021. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Mar 2, 2021, Mar 19, 2019 (2 updates tracked since 2019).

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About Mr. Ali Reza Rafatjoo M.d. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

MR. ALI REZA RAFATJOO M.D. (NPI 1154341907) is an individual family medicine provider in Newport Beach, California, licensed in California (A54980) and active in the NPI registry since July 2006. He is enrolled in Medicare PECOS and is a graduate of University Of California, Irvine, California College Of Medicine (1994).

NPPES Registry Identity

NPI1154341907

Entity TypeIndividualMale

Primary Taxonomy207Q00000X

Provider Legal NameMR. ALI REZA RAFATJOOCredential: M.D.

Location Address360 SAN MIGUEL DR, SUITE 206Newport Beach, CA 92660-7853

Mailing Address360 San Miguel Dr, Suite 206Newport Beach, CA 92660-7853 · (949) 640-4455 · Fax (949) 640-4456

Phone(949) 640-4455

Fax(949) 640-4456

Sole ProprietorYes

Medical School CMSUniversity Of California, Irvine, California College Of MedicineGraduated 1994

Enumeration DateJuly 21, 2006

Last NPPES UpdateMarch 2, 20212 updates tracked since enumeration

NPPES CertifiedMarch 2, 2021

✔ NPI 1154341907 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207Q00000X

License✔ Licensed in CA · A54980

Definition

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

360 SAN MIGUEL DR, Newport Beach, CA 92660

Open in Google Maps ↗

Other Identifiers 1

OtherA054980CA · Medical License

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Mr. Ali Reza Rafatjoo M.d. is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6204845662

PECOS Enrollment IDI20060412000384

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Areas of Expertise CMS Part B claims 12

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Established patient office or other outpatient visit with high level of medical decision making, if using time, 40 minutes or more 99215

This service involves a follow-up appointment for existing patients, lasting between 40 to 54 minutes. During this time, your healthcare provider will assess your current health status, discuss any changes or concerns, review your treatment plan, and answer any questions you may have.

308 services122 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

89 services66 patients

Injection, ceftriaxone sodium, per 250 mg J0696

Ceftriaxone sodium is an antibiotic injection used to treat a variety of bacterial infections. Each injection contains 250 mg of the medicine. It works by stopping the growth of bacteria in your body.

70 services15 patients

Chronic care management services, first 20 minutes of clinical staff time directed by health care professional, per calendar month 99490

Chronic care management services involve a healthcare professional directing clinical staff in managing your chronic conditions. This includes the first 20 minutes per month of services like medication management, care coordination, and health monitoring to help improve your health and quality of life.

41 services25 patients

Annual wellness visit, includes a personalized prevention plan of service (pps), subsequent visit G0439

An annual wellness visit is a yearly appointment with your primary care provider to create or update a personalized prevention plan. This plan helps prevent illness based on your current health and risk factors. It's a subsequent visit, meaning it follows an initial assessment.

32 services32 patients

Detection test by immunoassay with direct visual observation for severe acute respiratory syndrome coronavirus 2 (covid-19) 87811

This is a test to detect COVID-19, the virus causing severe respiratory illness. It uses a method called immunoassay, which identifies the virus by its unique proteins. The test is directly observed for accuracy. It helps determine if you're currently infected.

29 services24 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

22 services17 patients

Inhalation treatment for airway obstruction or sputum production 94640

Inhalation treatment, also known as nebulizer therapy, helps clear airway obstructions and reduce sputum production. It involves breathing in medication through a device, turning it into a mist. This can open up the airways, making breathing easier and helping to cough out mucus.

21 services18 patients

Injection of drug or substance under skin or into muscle 96372

This procedure involves administering medication directly under the skin or into a muscle. A small needle is used to inject the drug, allowing it to be absorbed quickly into the bloodstream. It's a common method for delivering a variety of medications.

19 services13 patients

Stool analysis for blood to screen for colon tumors 82270

A stool analysis for blood is a non-invasive procedure used to check for the presence of hidden blood in your stool. This can be an early sign of colon tumors. The test involves collecting a small sample of stool at home and sending it to a lab for analysis.

18 services18 patients

Routine electrocardiogram (ecg) using at least 12 leads with interpretation and report 93000

An electrocardiogram (ECG) is a non-invasive test that records your heart's electrical activity. Using 12 leads attached to your body, it captures data to help identify heart conditions. A doctor interprets the results and provides a report.

18 services17 patients

Albuterol, inhalation solution, fda-approved final product, non-compounded, administered through dme, unit dose, 1 mg J7613

Albuterol is a medication used to treat breathing problems. It is administered as an inhalation solution through a device called DME (Durable Medical Equipment). The solution is FDA-approved and non-compounded. Each unit dose contains 1 mg of the medicine.

13 services12 patients

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 92660 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$96.36 typical visit price

range $62.96 – $187.60

Typical copayment $24.09 (range $15.74 – $46.90)

Most-billed visit code 99203

Established Patient

$109.96 typical visit price

range $20.84 – $153.61

Typical copayment $27.49 (range $5.21 – $38.40)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

Reported Quality Measures

Adult Sinusitis: Computerized Tomography (CT) for Acute Sinusitis (Overuse)

Percentage of patients aged 18 years and older with a diagnosis of acute sinusitis who had a computerized tomography (CT) scan of the paranasal sinuses ordered at the time of diagnosis or received within 28 days after date of diagnosis

Lower rates are better for this measure.

4%27 patients

Breast Cancer Screening

Percentage of women 50-74 years of age who had a mammogram to screen for breast cancer

29%76 patients2/55-star benchmark: 92%

Care Plan

Percentage of patients aged 65 years and older who have an advance care plan or surrogate decision maker documented in the medical record that an advance care plan was discussed but the patient did not wish or was not able to name a surrogate decision maker…

2%105 patients1/55-star benchmark: 100%

Colorectal Cancer Screening

Percentage of adults 50-75 years of age who had appropriate screening for colorectal cancer

61%210 patients3/55-star benchmark: 85%

Documentation of Current Medications in the Medical Record

Percentage of visits for patients aged 18 years and older for which the eligible professional or eligible clinician attests to documenting a list of current medications using all immediate resources available on the date of the encounter.

100%1,058 patients5/55-star benchmark: 100%

e-Prescribing

At least one permissible prescription written by the MIPS eligible clinician is queried for a drug formulary and transmitted electronically using certified EHR technology.

98%3,419 patients4/55-star benchmark: 99%

Health Information Exchange

The MIPS eligible clinician that transitions or refers their patient to another setting of care or health care clinician (1) uses CEHRT to create a summary of care record; and (2) electronically transmits such summary to a receiving health care clinician for…

62%438 patients3/55-star benchmark: 88%

Medication Reconciliation

The MIPS eligible clinician performs medication reconciliation for at least one transition of care in which the patient is transitioned into the care of the MIPS eligible clinician.

99%114 patients4/55-star benchmark: 100%

Preventive Care and Screening: Influenza Immunization

Percentage of patients aged 6 months and older seen for a visit between October 1 and March 31 who received an influenza immunization OR who reported previous receipt of an influenza immunization

21%304 patients1/55-star benchmark: 88%

Provide Patient Access

At least one patient seen by the MIPS eligible clinician during the performance period is provided timely access to view online, download, and transmit to a third party their health information subject to the MIPS eligible clinician's discretion to withhold…

93%527 patients4/55-star benchmark: 100%

Secure Messaging

For at least one unique patient seen by the MIPS eligible clinician during the performance period, a secure message was sent using the electronic messaging function of CEHRT to the patient (or the patient-authorized representative), or in response to a secure…

13%527 patients1/55-star benchmark: 89%

View, Download, or Transmit (VDT)

At least one patient seen by the MIPS eligible clinician during the performance period (or patient-authorized representative) views, downloads or transmits their health information to a third party during the performance period.

27%527 patients

Providers report different measures because they deliver different services; reporting more or less information is not a reflection of quality. Star ratings appear only where CMS assigned them.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JOHN M. SCHWAB, M.D., A MEDICAL CORPORATION

Anesthesiology

360 SAN MIGUEL DR, #207
NEWPORT BEACH, CA 92660

Orange County (949) 721-1113

DR. ROBERT GERTMENIAN BURNS M.D.

Surgery

360 SAN MIGUEL DR, SUITE 608
NEWPORT BEACH, CA 92660

Orange County (949) 760-1144

REX C. MOODY D.S.S.

Dentist (Oral and Maxillofacial Surgery)

360 SAN MIGUEL DR, SUITE 402
NEWPORT BEACH, CA 92660

Orange County (949) 760-1600

NEWPORT ANESTHESIA ASSOCIATES

Specialist

360 SAN MIGUEL DR, SUITE 406
NEWPORT BEACH, CA 92660

Orange County (949) 759-0995

CHALINEE JILL INTARACHOTE D.P.T.

Physical Medicine & Rehabilitation

360 SAN MIGUEL DR, 301
NEWPORT BEACH, CA 92660

Orange County (949) 759-0300

MATTHEW O'MAHONEY D.P.T.

Physical Therapist

360 SAN MIGUEL DR, 301
NEWPORT BEACH, CA 92660

Orange County (714) 759-0300

NICHOLAS ELIAS ROSE M.D.

Orthopaedic Surgery (Hand Surgery)

360 SAN MIGUEL DR, SUITE#701
NEWPORT BEACH, CA 92660

Orange County (949) 759-3600

RIVIERA MEDICAL CORPORATION

Family Medicine

360 SAN MIGUEL DR, SUITE 107
NEWPORT BEACH, CA 92660

Orange County (949) 760-8300

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Ali Rafatjoo's NPI number?

The NPI number for Ali Rafatjoo is 1154341907. It was assigned to this individual provider in the NPPES registry on July 21, 2006.

Where is Ali Rafatjoo located?

Ali Rafatjoo practices at 360 San Miguel Dr Suite 206, Newport Beach, CA 92660. The listed phone number is (949) 640-4455.

What is Ali Rafatjoo's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Ali Rafatjoo enrolled in Medicare?

Yes. Ali Rafatjoo is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Ali Rafatjoo was last updated on March 2, 2021. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 5 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.